Fat Distribution and Major Depressive Disorder in Late Adolescence

Abstract

Objective Substantial evidence exists to indicate bidirectional relationships between obesity and depressive disorders and the importance of fat distribution to this relationship. This analysis used a well-characterized sample of individuals in late adolescence to determine the association between depressive illness and fat distribution. Method Medically healthy, 15 to 20 year-olds, one-half of whom had recently begun treatment with a selective serotonin reuptake inhibitor underwent a comprehensive psychiatric evaluation that resulted in diagnostic classification and weekly psychiatric disorder ratings over the prior 4 months, using the Longitudinal Interval Follow-up Evaluation. A whole body scan, using dual x-ray absorptiometry, allowed estimatiions of total body less head (TBLH), total mass, fat mass, and visceral adipose tissue mass (VAT). Assessments occurred between September 2010 and April 2014. linear regression analyses, adjusted for relevant covariates, examined the association between DSM-IV-TR major depressive disorder (MDD) and VAT. These procedures also determined whether significant associations were confined to overweight/obese participants. Results The analysis included data from 200 participants (71% females, mean age: 19.0±1.6 years), of whom 128 had current MDD. The presence of MDD was associated with increased fat mass among overweight/obese (Cohen’s d=0.79, p<0.002), but not normal weight, participants. This was true of both visceral and non-visceral fat mass measures. Accounting for the presence of generalized anxiety disorder did not alter the findings. Conclusion In adolescents, relationships between central adiposity and MDD may be confined to those who are overweight/obese. Despite the high co-morbidity of GAD and depressive disorders, only the latter appeared to be significantly associated with central adiposity.

Body Composition in Adolescents During Treatment With Selective Serotonin Reuptake Inhibitors

“…8 Oftentimes, increased appetite in MDD is associated with the atypical subtype. However, the prevalence of MDD with atypical features in our participants was low, 27 perhaps explaining the inverse association between MDD and depression that we observed.…”

“…** P < .10. more visceral and subcutaneous fat. 27 More importantly, despite some inconsistencies, longitudinal studies have generally found that MDD predicts the development of obesity over time, regardless of age, sex, or racial and ethnic background. 1,8,28 When MDD was categorically defined in our sample (ie, as defined in the DSM-IV-TR), it failed to predict changes in BMI z score.…”

The Role of Genetic Variation of BMI, Body Composition, and Fat Distribution for Mental Traits and Disorders: A Look-Up and Mendelian Randomization Study

“…The SNPs for body composition and body fat distribution (WC, HC, WHR, BF%, and BFM) associated with mental disorders/traits were all simultaneously associated with BMI. Hence, an isolated effect of body fat distribution on mental phenotypes implied by clinical and epidemiological studies (Luppino et al, 2010;Berkowitz and Fabricatore, 2011;Gurpegui et al, 2012;Luppino et al, 2014;Mühlig et al, 2015;Cortese et al, 2016;Coryell et al, 2016;Nigg et al, 2016), was not substantiated. In the MR analysis, we did not detect a general causal effect of body fat distribution on schizophrenia.…”

“…Particularly well analyzed are associations between obesity and depression (Luppino et al, 2010;Berkowitz and Fabricatore, 2011;Mühlig et al, 2015;Milaneschi et al, 2019) and ADHD (Cortese et al, 2016;Nigg et al, 2016), respectively. For obesity and MDD, a bidirectional, partly sex dependent relationship applies, entailing that obesity can precede MDD and vice versa (Luppino et al, 2014;Mühlig et al, 2015;Coryell et al, 2016). An association with obesity was also reported for BD and schizophrenia (Gurpegui et al, 2012).…”

Identification of psychiatric patients with high mortality and low medical utilization: a population-based propensity score-matched analysis

“…From the perspective of comorbidity, psychosomatic susceptibility and pathological changes might lead to the potential bidirectional relationship between mental disorders and cancer [50], thus increasing the mortality of this vulnerable population [51]. Furthermore, certain psychiatric medications that slow down metabolism could increase body weight and further contribute to the developments of endocrine disorders and cardiovascular diseases [52,53]. The psychophysiological conditions of psychiatric patients are closely related to the subsequently high mortality and medical expenditure per capita determined.…”